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Registration/Donation Form

TEN Celebration of the Performing Arts

Teen Outreach Summit/Expo

Saturday, March 30, 2019

10:00 a.m. to 2:30 p.m.

Name of Organization: ___________________________________________

Address: ______________________________________________________

Contact Person: ________________________________________________

Phone Number: ________________________________________________

______ Booth(s) x $80.00 = $____________

Donation: $__________________________

Total: $______________________________

Information to be provided in directory (ex: organization’s focus, services, or goals):

________________________________________________________________

________________________________________________________________

________________________________________________________________

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Needs (WiFi, electrical outlet, etc.): ___________________________________

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Please return completed form to teenenrichment@gmail.com no later than Monday, March 25, 2019, to reserve your spot. Checks should be made payable to:

Teen Enrichment Network7124 Salem Fields Blvd.

PMB# 121Fredericksburg, VA 22407-2509

Donations can also be made at https://www.gofundme.com/teen-enrichment-scholarship-fund.